Review of 'Ambulance Trains' by Alison Kay (March 2017)

Ambulance trains, as we would recognise them, came into service during the Boer War in South Africa at the beginning of the twentieth century.

In 1914 the first ambulance trains used French rolling stock (most resembled wagons used for transporting animals and freight) to bring casualties from an ever-changing front line. Once the Western Front settled into the line we recognize, ambulance trains dedicated to the BEF became operational.

Ambulance trains would transport wounded from Casualty Clearing Stations (CCS) to the base hospitals on the coast. Wounded men who were sent back to the UK sailed from Boulogne to either Dover or Southampton where they would be met by ambulance trains in the UK which did not move to France.
A typical train was one third of a mile long, it could carry around 500 wounded with bunks used as travelling wards.

The trains were made up of standard carriages converted for the purpose of carrying wounded soldiers. Also, on each train, there was a kitchen, a pharmacy and staff quarters.  Each train was staffed by three doctors, three nurses, three chefs and over forty orderlies, all of whom were male. These trains were often paid for by benevolent societies. The Friends Society (Quakers) contributed to and staffed three ambulance trains with conscientious objectors as the orderly staff. The Friends Society also produced and printed a regular magazine for ambulance train users, these magazines have proved to be a valuable record of what went on, there being very little outside personal accounts of the experience of working or using ambulance trains in the archives or in print.

One of the major problems faced by the staff on these trains was the transference of mental cases. In order to ensure the safe travel of these sick men, an orderly was instructed to sit with the patient for the entire journey. In order to ensure 24-hour attendance, each orderly was stood down after two hours. In times of the greatest need, after major offensives, a train might be expected to carry as many as 800 wounded. This was only possible if a third of the wounded travelled lying on the floor as well as the full complement in the bunks. Another problem was the use of toilets. Each train was equipped with toilets and baths for the staff only. The wounded were expected to use latrine buckets which had to be emptied on a regular basis. Deaths of these trains were a very rare occurrence, triage at the CCS eliminated the most likely to die, and emergency operations to reduce haemorrhaging were often carried out while the train was in motion.

After leaving Dover (or Southampton), each train would convey the wounded to designated cities with hospitals (like York) distributed all over England. When a train had discharged its wounded at the base hospital, it would be taken out of service and cleaned thoroughly before being used again. By 1918 there were between 30 and 40 ambulance trains on each side of the channel. After cleaning, the train would make its way back empty to the port (UK) or to the CCS (France).

At the end of the war all the carriages were converted back to their original state for peace time use.

Report by Peter Palmer